Surgical instrument



May 2, 1933.

R. J. PAGE 1,907,200

SURGICAL INSTRUMENT Filed April 22, 1951 A TTORNEY Patented May 2, 1933 LWLZGO easier ROSARIO 3'. PAGE, OF FORT KENT, MAINE SURGICAL INSTRUMENT Application filed April 22,

, This invention relates to improvements in surgical instruments or tonsillotomes for removing tonsils. p V

i The main object of the invention is to provide a simple and efficient instrument of this kind in which provision is made for exerting a powerful cutting pressure and in which said pressure is'applied easily and conveniently with the hand holding the instrument without requiring any held from the other hand thus leaving that hand free for other occupations. Y 1

Another object is to provide an instrument of the above character in which the nose or scoop thereof is so formed as to readily penetrate between the tonsil and its seat so that the tonsil may be operated upon, this action greatly facilitating the removal of stumps or remnants of tonsils and small tonsils. 7

With these and other objects in view as will be hereinafter apparent the invention resides in the novel construction and arrange ments of parts as hereinafter set forth and claimed, reference being had to the accompanying drawing wherein:

Figure 1 is a side view of the instrument showing the clamping lever both in its initial and final position, the latter being shown in dotted lines. I r

Figure 2 is a plan view'of the instrument.

Figure 3 is an enlarged section along the line 3-3 in Figure 2.

Figure 4 is a perspective view of an attachment by the use of which the clamping lever may be applied for use upon existing instruments of conventional form.

Figure 5 isa detail view showing the action of the improved nose portion or scoop as disclosed herein. V 1 g V Figure 6 is a view similar to Figure 5 but showing the action of theconventional nose portion or scoop.

The instrument comprises a handle 1 to which is secured an arm or frame 2, which extends forwardly from the handle and is 1931. Serial No. 531,985.

flat on its upper face 3. At its forward end the arm is widened to provide what is heremafter referred to as the nose portion or scoop 4 the side and end margins 5 of which are turned upwardly and then inwardly to provide slideways 6 for a purpose to be' described. The extreme end 7 of the nose portion at is rounded and an aperture 8 is provided therethrough inwardly of said margins 5 this aperture 8 being commonly known as the fenestrum. The cutting blade 9 is flat and is formed of the forwardly disposed head 10 and the rear or tail portion 11 connected by the relatively reduced or narrow shank 12. The head 10 of the cutter is sharpened at its forward end 13 and is rounded to substantially conform to the curvature of the rounded end of the nose portion 4. The blade 9 is mounted on the flat upper face 3 of the arm 2 and the head 10 is slidably mounted by its lateral edges in the slideways 6 described. An upwardly arched or bowed retaining spring 14 is mounted over the shank 12 of the blade 9 and is detachably held in place thereon by a rivet 15 or similar fastener passed loosely through an elongated longitudinal slot 16 in said shank 12 and detachably secured in the arm 2. This spring 14 and its detachable mounting are conventional in form and serve to hold the blade 9 in place on the instrument yet allow longitudinal movement of the blade upon the arm 2. From the foregoing it will be apparent that the blade 9 may be forced forward over the arm 2 by simply pressing upon the rear edge of its tail portion 11 with the thumb of the hand grasping the handle 1, the head 10 of the blade thus moving forward in the slideways 6 over the fenestrum 8.- As the head 10 moves forward its. cutting edge 13 enters into a narrow slot 17 in thenose of the arm 2 thereby facilitatingthe cutting action of the blade as will be hereinafter pointed out.

In order to increase the, pressure which may be exerted on the blade in pushing it forf it ward to perform its cutting function I rovide the means now to be described. ide plates 18 are secured to or formed integrally with the handle 1 at its upper end and extend upwardly in parallelism therefrom alongside the arm 2 and the tail portion 11 of the cutting blade 9. Upwardly of these elements the side plates 18 are turned or extended rearwardly and are provided with hooks 19 the mouths of which open forwardly as shown. A pressure lever 20 is provided and the same is curled around 'or otherwise secured at its end to a pivot pin 21 which extends laterally at each end therefrom. This pressure lever 20 is of such width at the end bearing the pin 21 as to fit loosely between the hooks 19 when the ends of the said pin 21 are placed therein to provide a hinge upon which the lever may swing. The lever 20 is adapted to engage and bear against the rear edge of the tail portion 11 of the cutting blade 9 so that by forcing the lever downwardly and forwardly toward the handle 1 the cutting blade will be forced forwardly. In the use of the device the handle 1 is grasped by one hand and the thumb thereof is used to force the blade 9 forwardly as far as possible, the pressure lever 20 being readily held upward out of the way by the thumb. When the blade has been forced as far forward as possible by the thumb the thumb is moved sideways allowing the lever 20 to drop clownward. The lever may then be forced home by simply closing the hand and it will be apparent that a powerful pressure will be exerted on the cutting blade by the use of a comparatively little force with the hand, it being further apparent that the hand grasping the handle 1 accomplishes the entire operation easily and conveniently. A. latch 22 is secured by its tong 23 to the lower portion of the handle 1 and extends rearwardly therefrom to lie in the path of the free end 24 of the pressure lever 20, the said latch having a plurality of angular notches 25 adapted to engage said end 24: of the lever and so hold the lever in an adjusted position. The latch 22 is formed of spring material to facilitate its operation as will be understood and to permit the disengagement ofthe lever therefrom when desired. At its rear end thecutting blade 9 carries a pin 26 which projects laterally at each end therefrom thus providing a convenient bearing for the lever 20 in forcing the blade forwardly as well as a projection by means of which the blade may be readily drawn rearwardly.

The operation of the instrument in removing the tonsils is similar to that of other instruments of its kind, the instrument being first introduced at the base of the tonsil and the tonsil then forced through the fenestrum '8 by pressing with the index finger 'of the free hand at the angle of the lower 3' aw upon the anterior pillar. When the tonsil is well pushed through the fenestrum the cutting blade 9 is pushed forward with the thumb causing the enucleation of the tonsil. The thumb however is not always able to exert a suflicient pressure to accomplish this action and the pressure lever 20 is then brought into play as described completing the operation. It is a very desirable and advantageous feature of the present invention that only one hand is needed in the operation of the cutting blade and pressure lever, other instruments utilizing a thumb screw or similar element for exerting the additional pressure which require the use of the other hand and require its removal from the pillar with a consequent movement of the tonsil.

The nose portion 4 of the instrument together with the inturned margins 5 thereof constitute what is generally known as the scoop by means of which the tonsil is to be forced or drawn outward from its seat to enter the fenestrum 8. Referring-to Figure 6 the scoop of usual form is shown wherein the upper margin of the nose portion 4 around its rounded end 7 is formed with rather blunt and rounded lip as shown at 27. This blunt lip or scoop will not penetrate between the tonsil A and its seat B but will tend to press into and deform the tonsil as clearly shown. In accordance with my invention the end 7 of the instrument is provided with a lip drawn to a rather sharp point 28 and being tapered outwardly and upwardly from the fenestrum 8 to its upper edge as shown at 29. The forward margin or face of the lip however is not tapered but is substantially perpendicular to the plane of the arm 2. The action of this form of scoop is clearly shown in Figure 5, it being evident therefrom that this relatively pointed scoop will penetrate between the tonsil A and its seat B and will facilitate the entrance of the tonsil into the fenestrum. This form of scoop is of particular advantage in the removal of remnants or stumps of tonsils as well as small tonsils and further prevents the leaving of stumps or remnants when doing the initial removing of the tonsils. It will be obvious also that this form of scoop might be applied to tonsillotomes of conventional form if so desired and such is considered within the scope of the present invention.

In Figure 4 is shown an attachment by means of which the pressure. lever 20 may be mounted upon a tonsillotome of conventional form, this attachment including the side-"plates 18a and hooks 19a similar to'and for the same purpose as the plates 18 and hooks 19 hereinbefore described. The side plates 18a are connected at their ends by a cross piece located at what would be their forward edges. The attachment may be placed over the handle of a conventional tonsillotome (not shown) with the plates 18a extended upward therefrom and be held in place thereon by the plates 18a themselves and the cross piece 30, the said cross piece 30 preventing the attachment from being pulled upward and rearwardly off the handle when the pressure lever is operated as will be readily understood.

From the foregoing it will be apparent that I have provided a very simple and effective instrument for the purposes specified. The instrument may of course be readily taken apart for cleaning and sterilizing and may be made in various sizes as desired.

While I have herein set forth a certain preferred manner and method of constructing any device it is understood that I may vary from the same in minor structural details so as best to construct a practical device for the purposes intended not departing from the spirit of the invention and within the scope of the appended claims.

I claim:

1. In a surgical instrument of the kind described, a handle, an arm extended from the handle, the said arm being laterally enlarged to provide a nose portion having a fenestrum near its end, a cutting blade slidably mounted on the arm and normally projecting rearwardly therefrom at its rear end, side plates extended upwardly from the handle at the sides thereof, hooks on the side plates, a pres sure lever, and a pin secured to one end of the pressure lever and adapted for releasable pivotal engagement with the hooks whereby the pressure lever may swing toward the handle and engage the rear end of the cutting blade to force the same forwardly.

2. In a surgical instrument of the kind described, a handle, an arm extended from the handle, the said arm being laterally enlarged to provide a nose portion having a fenestrum near its end, a cutting blade slidably mounted on the arm and normally projecting rearwardly therefrom at its rear end, side plates extended upwardly from the handle at the sides thereof, hooks on the side plates, a pressure lever, and a pin secured to one end of the pressure lever and adapted for releasable pivotal engagement with the hooks whereby the pressure lever may swing toward the handle and engage the rear end of the cutting blade to force the same forwardly, and a spring set latch secured to the end of the handle and having notches adapted to releasably engage the free end of the said pressure lever.

3. In a surgical instrument of the kind described, a handle, an arm forwardly extended upon its inner face from the point of juncture of the lip and the fenestrum outwardly, whereby a tapered structure is provided for facilitating working a tonsil from its seat and into and through the fenestrum.

In testimony whereof I affix my signature.

' ROSARIO J. PAGE.

from the handle, side plates extended upwardly from the handle, forwardly opening hooks formed at the upper ends of the side plates, a pressure lever, and a pin secured laterally across the end of the pressure lever and adapted for pivotal mounting in the said ooks. 

